How much rates vary
Facilitymedian $331 · 10th to 90th $229 to $537Professionalmedian $316 · 10th to 90th $234 to $4,169
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $245.47 | Facility | None | $234.42 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $346.74 | Professional | None | $234.42 | $245.47 | $346.74 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $316.23 | Professional | None | $251.19 | $251.19 | $316.23 |
Christus Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,073.80 | $4,168.69 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $295.12 Typical High $537.03 | Facility | None | $169.82 | $295.12 | $537.03 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $426.58 | Professional | None | $234.42 | $245.47 | $426.58 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $295.12 Typical High $295.12 | Professional | None | $81.28 | $295.12 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $537.03 | Facility | None | $229.09 | $331.13 | $537.03 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
United Setting Facility Modifier None Typical Low $354.81 Median $363.08 Typical High $616.60 | Facility | None | $354.81 | $363.08 | $616.60 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $380.19 | Professional | None | $204.17 | $281.84 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $46.77 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $46.77 | $48.98 | $60.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $30.20 |
Where Texas sits
The same service costs 4.1 times more in Hawaii than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 38th of 51
$324
HI $1,000FL $245
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.